CDR RD Exam Prep Online

Phosphorus should be prioritized because the client has hyperphosphatemia along with an elevated PTH, consistent with CKD-mineral and bone disorder risk. Limiting dietary phosphorus helps reduce phosphorus burden and can help mitigate secondary hyperparathyroidism and related bone and cardiovascular complications. The choice mentioning potassium is less appropriate because the client’s potassium is within the normal range. The choice mentioning sodium is not the top priority in this specific scenario because blood pressure is controlled and there is no edema provided to suggest sodium/fluid-related volume issues driving the current plan. The choice mentioning protein is not the best answer here because the client’s current intake is already around 0.8 g/kg/day, which is commonly within the recommended range for many non-dialysis CKD prescriptions; the immediate lab-driven concern is elevated phosphorus.

Using a production forecast based on historical utilization (such as prior meal counts and tray-return data) directly addresses the cause of the waste: producing more food than patients are likely to consume. Adjusting production targets to expected demand reduces excess food prepared and discarded. The choice about increasing portion sizes can increase leftovers and does not reduce overproduction. The choice about preparing smaller batches more frequently may help somewhat operationally, but without improving how demand is estimated, the department can still overproduce overall. The choice about switching to room service without tracking trends changes the service model but still lacks the demand forecasting and production control needed to reliably reduce waste.

A partial gastrectomy can cause dumping syndrome when a hyperosmolar, carbohydrate-rich liquid rapidly empties into the small intestine. In early dumping syndrome (typically within 10–30 minutes), fluid shifts into the intestinal lumen lead to abdominal cramping and diarrhea, often with vasomotor symptoms such as tachycardia, dizziness, and sweating. The choice mentioning shakiness and sweating occurring 2–3 hours describes late dumping, which is driven by an exaggerated insulin response causing reactive hypoglycemia and occurs later than the time frame given.